Sun spots are flat brown patches that build up on the skin the sun reaches most, such as the face, the backs of the hands and the chest. They are harmless, but they are a record of past sun exposure. A seborrheic keratosis is a common, harmless growth that looks stuck onto the skin, like a piece of wax or a small barnacle. They are not cancer and they do not become cancer. The reason to see a doctor is to be sure that is what you are looking at.
The same eight facts on every condition comparison.
It is a flat area of pigment.
A solar lentigo is a defined patch of increased pigmentation linked to ultraviolet exposure.
It appears on sun-exposed skin.
Spots often develop on the face, hands, forearms and shoulders.
"Liver spot" is a misnomer.
The common name does not mean the liver is involved.
Diagnosis comes first.
Atypical spots can resemble melanoma in situ, so uncertain lesions are examined before any cosmetic treatment.
It is a benign growth.
Surface skin cells form a waxy, warty or stuck-on growth.
Color varies.
It can be tan, brown, gray or almost black.
It is not a precancer.
These growths become more common with age.
Uncertain lesions are tested.
Tissue is examined before any destructive treatment if the appearance is unclear.
Flat brown spots Even tan to brown color.
Backs of the hands One of the most common sites.
Shoulders Clusters after years of sun.
Classic seborrheic keratosis Raised, waxy, stuck-on growth.
Stucco keratosis Small white-gray bumps on the legs.
Dermatosis papulosa nigra Small dark bumps on the face.
Repeated ultraviolet exposure changes pigment activity in a small area of skin. Extra melanin produces a persistent flat brown spot, rather than a raised growth.
A benign overgrowth of surface skin cells creates a localized plaque. Keratin and sometimes pigment collect in the growth, giving it a waxy, rough or stuck-on appearance.
Sun Spots. Usually become more noticeable in adult life after cumulative sun exposure.
Seborrheic Keratosis. Usually appears in adult life and becomes increasingly common with age.
Sun spots form when years of ultraviolet light make pigment cells produce extra melanin in one place. They build up slowly over decades.
Seborrheic keratoses are harmless growths of skin cells that become more common with age.
Fair skin that burns easily and a family history of sun spots make them more likely.
They often run in families.
Evidence labels come from each condition’s own treatment list.
Speeds up how quickly pigmented surface cells are shed, so spots lighten gradually from the top down. It is the over-the-counter option with the best evidence in sun spots, and it improves the surrounding sun-damaged skin at the same time. Start two or three nights a week to avoid irritation, and expect three to six months before the difference is obvious.
Loosens the pigmented cells at the surface so they shed sooner, which lifts a little color out of a spot over months. It works better as the thing that helps a lightening cream get in than as a treatment on its own. Used too often it leaves skin irritated and more sun-sensitive, which on this page is exactly the wrong direction.
Applied to dry skin, left for about fifteen minutes and washed off rather than left on overnight. It suits people who want a lightening step without hydroquinone, or something to hold a result between courses of it. Most of the trial evidence is in melasma rather than sun spots, and the smell is the usual reason people stop.
A gentler relative of hydroquinone that releases a small amount of it slowly in the skin. It is a reasonable long-term option on a spot you are lightening slowly, and it does not sting, which matters because irritation on a sun spot can leave a darker mark. The effect is mild and takes months.
Lightens surface pigment modestly and adds a little to what sunscreen is doing during the day. It is easy to keep using for years, which is its real advantage here, since sun spots are a long game. On its own it will not clear an established spot.
Slows the handover of pigment from pigment cells to the skin cells above them, so a spot fades a little rather than disappears. Its strength is that it is well tolerated and does not sting, so it sits comfortably alongside a retinol without making the skin sore. Modest on its own.
Blocks the same pigment-making enzyme hydroquinone does, more weakly. It is nearly always sold combined with other lightening ingredients, and the studies behind it are studies of those combinations. It stings some people, and irritation on a sun spot is not a neutral event, particularly on medium and deeper skin tones.
A strong urea cream can soften and flatten the rough white growths that scatter over the lower legs, called stucco keratoses, if the roughness is what bothers you. It smooths the surface rather than removing the growth, and it has to be used continuously. It does nothing for thick, dark, stuck-on growths elsewhere.
Wart treatments are often tried on these because the surface looks similar. Salicylic acid can thin the rough top layer, but it does not clear the growth, and it irritates the normal skin around it. The bigger problem is that it is usually being used on something nobody has examined.
This is aftercare, not treatment. A thin layer of plain petroleum jelly over a treated spot keeps the scab soft and gives the neatest healing, under a small dressing rather than an adhesive strip. It does nothing to a growth that is still there.
Daily mineral sunscreen over a spot that has just been treated stops the temporary mark from darkening and helps it fade faster, which matters most on the face, chest and hands. It will not remove a growth or stop new ones forming. Sun is only one of several things that drive these, and age and family history matter more.
The strongest cream for lightening a sun spot, applied thinly to the spot itself rather than the skin around it. It is used in a defined course of about three to four months with a break afterwards, not indefinitely, and it works best combined with a retinoid. It is slower than a single session of freezing or laser, and it is the option to prefer when treatment risk on deeper skin tones is the concern.
The prescription retinoid, and the one with real trial evidence in sun spots specifically. It lightens spots over about six to ten months and improves the sun-damaged skin around them at the same time. Expect dryness and flaking early on, and use it at night with daily sunscreen, since it leaves skin more sun-sensitive. Ask your doctor about it if you are pregnant or trying to become pregnant.
A stronger retinoid with good trial results in sun spots, used when tretinoin has not done enough. It works the same way, a little faster, and irritates more, so it is often started a few nights a week. Ask your doctor about it if you are pregnant or trying to become pregnant.
A high-strength peroxide solution applied in clinic was approved for raised growths on the face and body. It cleared some growths, often needed repeat visits, and commonly caused stinging, crusting and pigment change. It was withdrawn from sale in the United States, so in practice removal is done by hand rather than with a liquid.
A few seconds of liquid nitrogen on each spot, done in the room, no anesthetic needed. The spot darkens, crusts and lifts off over one to two weeks. It suits a small number of spots rather than a whole hand, and its known cost is a permanent pale mark where too many pigment cells were destroyed, which is a bigger risk on medium and deeper skin tones.
IPL. The best option when there are many spots across a whole area such as the face, chest or the backs of the hands. Usually one to three sessions, with the spots darkening and flaking off over one to two weeks after each. It is aimed at contrast between spot and skin, so it works best on lighter tones and is used cautiously or not at all on deep skin.
The same pigment-shattering laser used for tattoo ink is used at low energy on individual sun spots, and it clears them reliably in one or two sessions. It is more precise than intense pulsed light and better for a few stubborn spots rather than a whole area. Settings have to be matched to the skin tone, since too much energy leaves a pale or a dark mark behind.
Delivers its energy in much shorter pulses, which breaks up pigment with less heat spilling into the skin around it. That lower heat is the reason it is often chosen for medium and deeper skin tones, where a darker mark afterwards is the main worry. It costs more than the older lasers and the results in sun spots are broadly similar.
Lightens spots across a whole area rather than one at a time, which suits the backs of the hands, the forearms and the chest where spots are scattered widely. Usually a course rather than a single treatment, and the result is a general evening out rather than each spot disappearing. Depth matters: a peel strong enough to leave the skin raw can leave a darker mark instead.
Fraxel. Treats the sun-damaged skin as a whole rather than targeting individual spots, so it improves texture and fine lines alongside the pigment. That makes it a reasonable choice when the spots are only part of what is bothering you. For clearing spots alone it is slower, dearer and less precise than freezing or a pigment laser.
Polishes off the very top layer of skin, which makes it briefly smoother and brighter. The pigment in a sun spot is held in ridges below that layer, so it is not reached. It is often sold as a treatment for spots and it is not one, and repeated sessions can irritate skin enough to leave marks of their own.
A few seconds of liquid nitrogen makes flatter growths blister and lift off over a week or two, and it is the quickest way to treat several at once. It destroys the growth, so nothing can be examined afterward, which is why it is not used on anything with a question attached. It is used cautiously on the face and on deeper skin tones, because the pigment cells are sensitive to cold and it can leave a pale spot.
The growth is numbed and shaved off level with the skin in a few seconds. It is the method of choice when there is any question about what a growth is, because it produces tissue that can be sent to the laboratory. It leaves a flat mark that fades over months, and it does not stop new growths appearing elsewhere.
The growth is scraped off with a small curette and the base sealed with a fine electric tip. It is controlled and shallow, which is why it is often preferred for small facial growths and for the dark facial growths common on deeper skin tones. Scraping first still gives tissue that can be examined if there is doubt.
An ablative laser can vaporise a growth precisely and is sometimes used when several need treating on the face. Like freezing, it destroys the tissue, so it is only for growths already confirmed as harmless. It is the most expensive of the options and it is not better than a curette for a single growth.
When a growth is changing, bleeding on its own, or simply looks unlike your others, part or all of it is taken after numbing and examined under a microscope. It is the only way to be certain, and the threshold for doing it is deliberately low, because the cost of a small biopsy is trivial next to missing a melanoma. An irritated growth is one of the commonest reasons a benign growth ends up being sampled.
Sun spots usually persist and can increase with further ultraviolet exposure. They do not themselves become skin cancer, but sun-damaged skin can develop other lesions. A changing, rough or otherwise unusual spot needs assessment before cosmetic treatment.
Seborrheic keratoses appear slowly, change slowly, then stay. Two departures deserve attention: one growth that starts changing - growing, darkening, bleeding on its own, or itching persistently - and a sudden crop of many new ones over weeks to months.
Solar lentigines are benign, but they mark ultraviolet exposure and may coexist with other sun-damaged lesions. A changing or irregular spot needs assessment rather than an assumed age-spot diagnosis.
Catching on clothing makes it flare
A growth caught by clothing, a strap or a waistband can turn red, swollen, itchy, crusted or sore, and can bleed. That is an irritated seborrheic keratosis. It settles, but it looks alarming and often prompts removal or a sample.
Have a new, changing, unevenly colored or bleeding spot checked before using a fading treatment.
Have a new, changing, bleeding or uncertain growth assessed; skin cancer can sometimes resemble a harmless stuck-on growth.
The spots are harmless and do not turn into cancer. What they indicate matters - that much sun exposure makes other changes more likely, so watch and protect those areas.
The reassuring pattern is flat, one even color, a clear edge, stable over time, similar to its neighbors. The pattern that needs a check is changing, growing, more than one color, a ragged or blurred edge, itching, bleeding, or a spot unlike the rest. Being unsure is a reason to have it looked at, not to worry.
In-office treatment. Freezing works for a few spots; laser or intense pulsed light for many, usually over one to three sessions. Expect them to darken and flake off over one to two weeks. Creams work far more slowly.
The individual spot usually does not return. New ones keep appearing on sun-exposed skin unless the sun protection changes, which is why people who treat spots and change nothing else are back within a few years.
Sunscreen does not remove them, but it stops them darkening and slows new ones. Retinoids, vitamin C, niacinamide and short courses of hydroquinone lighten existing spots over three to six months, more gently than a procedure.
The one to be most cautious about. Freezing can destroy the pigment cells and leave a permanent pale mark, more noticeable on deeper skin tones and harder to correct than the original spot. Topical treatment first, conservative settings, a test spot, and a provider who treats deeper skin tones regularly is the safer path.
It could be, which is why it should be looked at rather than diagnosed at home. Melanoma is sometimes mistaken for a seborrheic keratosis, and a dermatoscope resolves most of these in seconds. The concerning features are change in size, shape or color, bleeding without being knocked, an irregular edge, and a growth unlike your others. Book rather than watch.
Age and family history account for nearly all of it. They accumulate steadily from the forties onward, and someone whose parents had many will develop many. A genuinely sudden crop over weeks to months, especially with itching, is different and worth examining.
No. Removal deals with that growth, not the age and inherited tendency behind it, so new ones can keep appearing elsewhere. That is expected, not a failed removal.
Often, at least for a while. A flat spot darker or paler than nearby skin is common, and dark marks usually fade over months. Pale marks can be permanent and are more noticeable on deeper skin tones, so ask about the method and do a test spot before treating a large area. Daily sunscreen on the treated spot makes a real difference.
Most likely it caught on clothing, a strap or a razor and became an irritated seborrheic keratosis. They look far worse than they are and they settle. Still have it looked at - an irritated growth is one of the harder ones to be sure about by appearance, and a growth that bled with nothing catching it is a different question.
As many as you and your doctor think sensible, usually in sessions rather than all at once. It is normally considered cosmetic, so ask about cost first. On the face, and particularly on deeper skin tones, start with a small test area and see how it heals.
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